The exposure of an organ to air, heat induced by the surgical illuminating lamps, and the environmental atmosphere causes drying of the organ surface and bacterial contamination of the surgical area. One of the principles for reducing risk to the organ during surgical intervention is to keep the tissue moist thus preventing drying of the organ surface. The loss of moisture at the organ surface results in cell death followed by enhanced tissue inflammatory reaction with the possibility of adhesions forming between the tissues involved. This risk is especially harmful to organs and tissues that do not have the capacity to regenerate their cells and where the tissue function relates intimately with the structure-function of the cells. Neurosurgical procedures involving the central nervous system, brain, or spinal cord, require continuous wetting of the organ surface. This also applies to surgeries involving the pancreas and intestines where the dry organ surface complicates, by well established pathogenic mechanisms, the postoperative outcome. These adverse effects can be reduced by covering exposed organs with surgical pads soaked in sterile saline or sterile Ringers solution. The disadvantage of this procedure, as currently followed, is that the gauze pad is not transparent thus prohibiting continuous inspection of the organ. The pad may also be in the way of the instruments, i.e., scalpel, scissors, etc.
In surgeries requiring retraction of the incised tissue by metallic retractors the pressure exerted by the instruments, especially during lengthy surgeries (several hours), may be detrimental to the viability of the tissue. In order to minimize the harmful effect of the pressure, a pad of wet gauze is commonly placed underneath the retractor to form a cushion between the tissue and the metal.
When instruments exert pressure on tissues, blood flow is restricted thus creating a poor oxygen supply. Also, mechanical disruption of tissue cells occurs not only with retractors, but with forceps, hemostats and instruments used mainly to compress a tubular organ, such as intestines, vessels, or esophagus. The surgeon generally places a plastic tube over the metal part of the instrument in order to reduce the compressing trauma to the tissue. However, such a plastic has no or minimal plasticity to function as a cushion.